I hereby authorize Cluck-U, Corp. and its agent(s) to thoroughly investigate my background, employment record, criminal record, credit history, and other matters related to my qualifications for a Cluck-U Chicken Brand unit. I authorize any person, including my current employer (if applicable), previous employers, credit reporting agencies, or other reporting persons or organizations contacted by Cluck-U, Corp. to provide any relevant information regarding this application or my history.

I waive my rights under the Privacy Act, 5 U.S.C. 552a and similar state laws.
By submitting responses to this questionnaire, I agree that Cluck-U, Corp. many rely on my responses.

I understand that misrepresentation or omission of facts may result in rejection of my application. By typing my name and submitting this questionnaire, I agree to all the preceding terms.